ABSTRACT
En la experiencia de los cirujanos, las hernias de la pared abdominal constituyen una enfermedad cuyo diagnóstico es básicamente clínico. Sin embargo, la hernia de Spiegel, por su infrecuente presentación (0,2 por ciento), sintomatología inespecífica y exploración anodina, pasa fácilmente desapercibida. Presentamos nuestra experiencia en 7 pacientes (2 por ciento) con hernia de Spiegel, analizando las dificultades diagnósticas que aconsejan con frecuencia el empleo de pruebas diagnósticas complementarias (AU)
Subject(s)
Adult , Aged , Female , Male , Middle Aged , Humans , Laparotomy , Hernia, Ventral/diagnosis , Hernia, Ventral/epidemiology , Hernia, Ventral/complications , Hernia, Ventral , Hernia, Ventral/surgery , Tomography, X-Ray Computed , Polypropylenes , Polypropylenes/adverse effects , Diagnosis, Differential , Abnormalities, Multiple/surgery , Abnormalities, Multiple/diagnosisABSTRACT
We present a case of acute abdomen due to a jejunal perforation. The final diagnosis was concluded a multiple endocrine neoplasia type I. In the literature reviewed, no similar clinical presentation was found. We review the diagnostic sequence and the management of these patients.
Subject(s)
Abdomen, Acute/etiology , Adenoma/diagnosis , Gastrinoma/diagnosis , Intestinal Perforation/etiology , Jejunal Diseases/etiology , Multiple Endocrine Neoplasia Type 1/diagnosis , Pancreatic Neoplasms/diagnosis , Parathyroid Neoplasms/diagnosis , Pituitary Neoplasms/diagnosis , Adenoma/complications , Adult , Gastrinoma/complications , Humans , Intestinal Perforation/surgery , Jejunal Diseases/surgery , Magnetic Resonance Imaging , Male , Multiple Endocrine Neoplasia Type 1/complications , Pancreatic Neoplasms/complications , Parathyroid Neoplasms/complications , Pituitary Neoplasms/complications , Tomography, X-Ray ComputedABSTRACT
A case of heterotopic pancreas located in the small intestine is herewith presented. The 19-years male patient had been admitted three times since 1991 for an anemic syndrome secondary to melena. The origin of the hemorrhage was not determined with the studies performed (intestinal transit, opaque enema, esophagogastroscopy, colonoscopy and gammagraphy with technetium 99). On the last admission a vascular lesion low flow was observed on arteriography of the upper mesenteric artery on the mesenteric edge of the proximal jejunum. Following laparotomy a small tumor was found in the jejunum and 5 cm of the intestine including the tumor was resected. The anatomic pathologic results demonstrated a heterotopic pancreas.
Subject(s)
Choristoma/complications , Gastrointestinal Hemorrhage/etiology , Jejunal Diseases/complications , Pancreas , Adult , Angiography , Choristoma/diagnostic imaging , Choristoma/surgery , Humans , Jejunal Diseases/diagnostic imaging , Jejunal Diseases/surgery , MaleABSTRACT
Primary pancreatic hydatidosis is exceptional. Only 12 cases have been reported in Spain up to 1982. In large series of patients with hydatidosis, pancreatic involvement occurs in 0.25% of cases. We describe a 55-yr-old man who was admitted to the hospital because of fever, epigastric pain, and abdominal mass. Endoscopy, upper gastrointestinal series, and computerized tomography revealed a fistula between the duodenum and the pancreatic tumor. At surgical exploration, a primary infected hydatid cyst in the head of the pancreas communicating with the duodenum was encountered. The cyst was removed and drained. We have been unable to find in the literature a review of this form of presentation of pancreatic hydatidosis.
